On Blacks and Fat: Dr. Michelle Gourdine

(The Root) -- Obesity is more common in African Americans than in other ethnic groups. But when it comes to black people and weight, that's where the agreement seem to ends. Is food the culprit? Is exercise the solution? Is there even a real problem to begin with, or should we be focusing on health -- or even self-acceptance -- rather than the number on the scale?

Against the backdrop of a first lady's mission to slim down the nation's kids, black celebs getting endorsements after shedding inches and a booming weight-loss industry, The Root will publish a series of interviews with medical professionals, activists and fitness enthusiasts that reveal the complexity of this issue and the range of approaches to it.

For the 12th in the series, we spoke to Dr. Michelle Gourdine, the author of Reclaiming Our Health: A Guide to African American Wellness,a book designed to help African Americans reduce their disproportionate burden of obesity, high blood pressure, cancer and other leading causes of death. The board-certified physician, public health professional and professor talked to us about her criticism of a recent study suggesting exercise is less effective for black girls, why "all calories are not created equal" and how she suggests black people balance a healthy acceptance of different body types with the hard numbers. "We know we can be beautiful and we can be confident at any weight," she says, "but part of that self-acceptance and self-love means paying attention to your physical health."

The Root: According to the latest statistics, African Americans are 1.5 times as likely as whites to be obese. What's going on, from your perspective, with black people, obesity and overall health?

Michelle Gourdine: What I think is going on with African Americans and obesity is the same thing that's going on with Americans in general. It has nothing to do with lack of willpower or genetic inferiority.

The same three factors that contribute to the obesity epidemic in the United States impact the African-American obesity crisis. First, we're a very sedentary society now. In generations past, our economy was agricultural. There was a lot of manual labor that was involved. Nowadays, we sit in traffic, in front of our computers and in meetings. Technology has taken away a lot of opportunities for us to move, which impacts our ability to burn calories and lose weight.

The second issue is the food we eat. We eat a lot more foods that come in cans and boxes, and a lot of processed foods. And it turns out that not all calories are created equal.

One hundred calories' worth of Twinkies is not equivalent to 100 calories' worth of broccoli. Twinkies not only have fewer of the vitamins and minerals and other nutrients that are beneficial to us, but they're also digested very quickly in the body, and they stimulate the production of insulin, which encourages the storage of fats, especially around our waists. So the overconsumption of those processed foods sets us up for obesity.

Third, our constant 24-7 lifestyle. I told my kids -- and they were shocked to hear this -- there used to be a time when midnight came, and if you were watching TV, you'd see the national anthem, and then the television would go off. They couldn't believe it, and that's a metaphor for our 24-7 lifestyle. We're always on, and that can be stressful. And stress has to do with gaining weight, because the stress hormones that circulate constantly in our bodies cause us to gain weight -- again, around the abdominal area.

TR:When it comes to African Americans and obesity, what is the biggest myth or misunderstanding?

MG: There's this prevailing myth, whether people admit it or not, that African Americans are obese because we like being fat. There have been a number of debates about it, and I don't believe it's true. One study that really upset me was the one that said that black teen girls don't benefit as much from exercise as white teen girls do.

They measured [physical activity] using an accelerometer, which does tend to be relatively objective, but they only made measurements over three days, and they based the largest part of the comparison between the physical activity of black girls and white girls on their self-report, which is open for interpretation.

Then, there was no accounting for the quality of diet that each of these girls ate during the period during which they were being monitored, and as I just stated, diet has a lot to do with weight gain. In fact, there have been studies that have shown that 75 percent of weight gain or loss is dependent on our diet.

Finally, when the study authors said black girls don't benefit as much from exercise, there was a very narrow definition of "benefit." We don't only benefit from exercise with weight loss. We also benefit by obtaining better control of our blood pressure, our blood sugar and our cholesterol, all of which, if they're not under control, set us up for serious disease. And there are also mental-health benefits related to exercise.

So my concern was that that study and the way it was interpreted in the media might discourage some young ladies who are very diligent about taking care of themselves from undertaking physical activity. And that would be a huge, huge mistake.

TR: If you could make just one suggestion for people to implement in their daily lives with respect to weight and health, what would it be?

MG: This one is really important to me. African-American women in general have a very accepting attitude about each other, and it's not dependent on size. In other words, we know we can be beautiful and we can be confident at any weight. But part of that self-acceptance and self-love means paying attention to your physical health.

There's a big difference between simply being curvy and being unhealthy. So the one suggestion I would make would be that, in addition to paying attention to the number on the scale, you pay attention to other numbers as well.

Just like you know your phone number and your Social Security number, you need to know your cholesterol, your blood sugar and your blood pressure and the size of your waist. These numbers, if they're off-kilter, are like a dashboard. They indicate that your arteries are clogging up, that you're not processing insulin properly, and that can mean you're teetering on the verge of diabetes, heart attack and stroke. So know your numbers so you can maintain a healthy weight and live a healthy life.

TR:Are there any other cultural, historical or psychological issues that you think make the black community's relationship with weight and health unique?

MG: In addition to our being more accepting of curves, which is something that's healthy, we tend to judge our weight in comparison to people who are our peers -- people who we're around at the job, in the neighborhood, et cetera. Black women might perceive themselves to be of normal weight because they might have friends or contemporaries or peers who are heavier than they are. But in fact, they're all obese.

Not to put too much emphasis on the weight number, but it's important to understand when you're moving toward that overweight and obese range. When the doctor measures your weight and tells you you're in that zone where you're headed toward overweight or obesity, pay attention to that. Don't harp on the number, but make sure you get the other information you need to make sure you're maintaining good health overall.